Provider Demographics
NPI:1346241668
Name:FOX-SMITH, LAURA (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FOX-SMITH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:130 TOWN CENTER DR STE 203
Mailing Address - Street 2:BEAUMONT MEDICAL STAFF AFFAIRS
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1744
Mailing Address - Country:US
Mailing Address - Phone:248-585-8218
Mailing Address - Fax:248-585-8266
Practice Address - Street 1:17000 KERCHEVAL AVE STE 205
Practice Address - Street 2:BEAUMONT GROSSE POINTE PHYSICIANS & SURGEONS
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48230-1570
Practice Address - Country:US
Practice Address - Phone:313-640-2424
Practice Address - Fax:313-640-2415
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2020-10-22
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Provider Licenses
StateLicense IDTaxonomies
MI4301050430207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2748683Medicaid
MIB44411Medicare UPIN
MIB44411Medicare UPIN